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Individual

DR. KEVIN JAMES KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
2800 CORNERSTONE DRIVE, SUITE 110, PAGOSA SPRINGS, CO 81147
(505) 699-0824
Mailing address
7 PEBBLE CIRCLE, PAGOSA SPRINGS, CO 81147
(505) 699-0824

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY5974
CA

Other

Enumeration date
08/20/2006
Last updated
03/08/2017
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